Breast Cancer Screening and Diagnosis Clinical Practice Guidelines in Oncology

2003 ◽  
Vol 1 (2) ◽  
pp. 242 ◽  
Keyword(s):  
Breast Cancer ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
Accurate Diagnosis ◽  
Effective Manner ◽  
Recent Version ◽  
Screening And Diagnosis ◽  
Made In

The key to a continued reduction in mortality from breast cancer is early detection and accurate diagnosis made in a cost-effective manner. These practice guidelines are designed to facilitate clinical decision making on the important issues in screening for breast cancer. For the most recent version of the guidelines, please visit NCCN.org

Breast Cancer Screening and Diagnosis Clinical Practice Guidelines

2006 ◽  
Vol 4 (5) ◽  
pp. 480 ◽  
Author(s):  
_ _
Keyword(s):  
Breast Cancer ◽  
United States ◽  
Practice Guidelines ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
The United States ◽  
Mammographic Screening ◽  
Effective Manner ◽  
Recent Version

The lifetime risk of a woman developing breast cancer has increased over the past 5 years in the United States: of every 7 women, 1 is at risk based on a life expectancy of 85 years. An estimated 214,640 new cases (212,920 women and 1,720 men) of breast cancer and 41,430 deaths (40,970 women and 460 men) from this disease will occur in the United States in 2006. However, mortality from breast cancer has decreased slightly, attributed partly to mammographic screening. Early detection and accurate diagnosis made in a cost-effective manner are critical to a continued reduction in mortality. These practice guidelines are designed to facilitate clinical decision making. For the most recent version of the guidelines, please visit NCCN.org

Routine monitoring of liver function tests in lung cancer resections – a necessary burden?

2019 ◽  
Vol 64 (3) ◽  
pp. 86-90
Author(s):  
NA Bradley ◽  
ED Kennedy ◽  
M Asif
Keyword(s):  
Decision Making ◽  
Liver Function ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision ◽  
Liver Function Tests ◽  
Function Tests ◽  
Routine Monitoring ◽  
Effective Manner ◽  
Collect Patient Data

Background Increased availability of routine investigations results in significant over-investigation, burdening patients with unnecessary tests as well as increasing cost. We aimed to identify the extent of monitoring of liver function tests in lung resections, and to ascertain whether any impact on clinical decision-making occurred. Methods Cases were identified using theatre records coded as “lobectomy/bilobectomy” in the three-month period 20 June 2017 to 20 September 2017. Electronic records were used to collect patient data. Results A total of 91 cases were included; 77 (85%) patients had 1 set of pre-operative LFTs, 12 (13%) patients had 2 sets, and 2 (2%) patients had 0 sets; 69 (76%) had normal LFTs pre-operatively; 298 sets of LFTs were measured post-operatively, with a median of 3 sets per patient; 61 (67%) patients had either normal or static LFTs post-operatively, 13 (14%) had isolated rise in GGT, 16 (17%) had derangement of ALT and AST, and 1 patient (1%) had deranged ALP. Altered clinical decision-making due to LFTs derangement was recorded in two cases (2%). Conclusion Clinicians have an obligation to justify expense, and practise in a cost-effective manner. Our data suggest that the routine perioperative monitoring of LFTs in thoracic surgery does not give any clear benefit to patient care.

scholarly journals Cancer Grade Model: a multi-gene machine learning-based risk classification for improving prognosis in breast cancer

2021 ◽  
Author(s):  
E. Amiri Souri ◽  
A. Chenoweth ◽  
A. Cheung ◽  
S. N. Karagiannis ◽  
S. Tsoka
Keyword(s):  
Breast Cancer ◽  
Machine Learning ◽  
Clinical Decision Making ◽  
Histological Grade ◽  
Tumour Size ◽  
Clinical Decision ◽  
Gene Signature ◽  
Risk Classification ◽  
Breast Cancers ◽  
Grade 3

Abstract Background Prognostic stratification of breast cancers remains a challenge to improve clinical decision making. We employ machine learning on breast cancer transcriptomics from multiple studies to link the expression of specific genes to histological grade and classify tumours into a more or less aggressive prognostic type. Materials and methods Microarray data of 5031 untreated breast tumours spanning 33 published datasets and corresponding clinical data were integrated. A machine learning model based on gradient boosted trees was trained on histological grade-1 and grade-3 samples. The resulting predictive model (Cancer Grade Model, CGM) was applied on samples of grade-2 and unknown-grade (3029) for prognostic risk classification. Results A 70-gene signature for assessing clinical risk was identified and was shown to be 90% accurate when tested on known histological-grade samples. The predictive framework was validated through survival analysis and showed robust prognostic performance. CGM was cross-referenced with existing genomic tests and demonstrated the competitive predictive power of tumour risk. Conclusions CGM is able to classify tumours into better-defined prognostic categories without employing information on tumour size, stage, or subgroups. The model offers means to improve prognosis and support the clinical decision and precision treatments, thereby potentially contributing to preventing underdiagnosis of high-risk tumours and minimising over-treatment of low-risk disease.

scholarly journals Nottingham Prognostic Index Plus (NPI+): a modern clinical decision making tool in breast cancer

2014 ◽  
Vol 110 (7) ◽  
pp. 1688-1697 ◽  
Author(s):  
E A Rakha ◽  
D Soria ◽  
A R Green ◽  
C Lemetre ◽  
D G Powe ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Prognostic Index ◽  
Clinical Decision ◽  
Nottingham Prognostic Index ◽  
Decision Making Tool

Practice Guidelines for the Diagnosis of COVID-19-Associated Pulmonary Aspergillosis in an Intensive Care Setting

2021 ◽  
pp. 088506662110471
Author(s):  
Zia Hashim ◽  
Zafar Neyaz ◽  
Rungmei S.K. Marak ◽  
Alok Nath ◽  
Soniya Nityanand ◽  
...  
Keyword(s):  
Intensive Care ◽  
Practice Guidelines ◽  
Clinical Management ◽  
Care Setting ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Third Wave ◽  
Intensive Care Setting ◽  
Pulmonary Aspergillosis

Coronavirus disease-2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is a new disease characterized by secondary Aspergillus mold infection in patients with COVID-19. It primarily affects patients with COVID-19 in critical state with acute respiratory distress syndrome, requiring intensive care and mechanical ventilation. CAPA has a higher mortality rate than COVID-19, posing a serious threat to affected individuals. COVID-19 is a potential risk factor for CAPA and has already claimed a massive death toll worldwide since its outbreak in December 2019. Its second wave is currently progressing towards a peak, while the third wave of this devastating pandemic is expected to follow. Therefore, an early and accurate diagnosis of CAPA is of utmost importance for effective clinical management of this highly fatal disease. However, there are no uniform criteria for diagnosing CAPA in an intensive care setting. Therefore, based on a review of existing information and our own experience, we have proposed new criteria in the form of practice guidelines for diagnosing CAPA, focusing on the points relevant for intensivists and pulmonary and critical care physicians. The main highlights of these guidelines include the role of CAPA-appropriate test specimens, clinical risk factors, computed tomography of the thorax, and non-culture-based indirect and direct mycological evidence for diagnosing CAPA in the intensive care unit. These guidelines classify the diagnosis of CAPA into suspected, possible, and probable categories to facilitate clinical decision-making. We hope that these practice guidelines will adequately address the diagnostic challenges of CAPA, providing an easy-to-use and practical algorithm to clinicians for rapid diagnosis and clinical management of the disease.

scholarly journals Analysing Breast Cancer Multidisciplinary Patient Management: A Prospective Observational Evaluation of Team Clinical Decision-Making

2018 ◽  
Vol 43 (2) ◽  
pp. 559-566 ◽  
Author(s):  
T. A. K. Gandamihardja ◽  
T. Soukup ◽  
S. McInerney ◽  
J. S. A. Green ◽  
N. Sevdalis
Keyword(s):  
Breast Cancer ◽  
Decision Making ◽  
Patient Management ◽  
Clinical Decision Making ◽  
Clinical Decision

scholarly journals Breast Cancer Screening and Diagnosis, Version 3.2018, NCCN Clinical Practice Guidelines in Oncology

2018 ◽  
Vol 16 (11) ◽  
pp. 1362-1389 ◽  
Author(s):  
Therese B. Bevers ◽  
Mark Helvie ◽  
Ermelinda Bonaccio ◽  
Kristine E. Calhoun ◽  
Mary B. Daly ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Clinical Practice ◽  
Cancer Screening ◽  
Breast Cancer Screening ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Screening And Diagnosis

Cost-Effective Clinical Decision Making

PEDIATRICS ◽  
1980 ◽  
Vol 65 (2) ◽  
pp. 371.1-371
Author(s):  
Edward J. O'Boyle
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Cost Effective ◽  
Clinical Decision

scholarly journals Controversies in Breast Cancer

1997 ◽  
Vol 4 (3) ◽  
pp. 226-235 ◽  
Author(s):  
Frank J. Cummings ◽  
Nabil Saba
Keyword(s):  
Breast Cancer ◽  
Clinical Decision Making ◽  
Ductal Carcinoma ◽  
Clinical Decision ◽  
Cancer Management ◽  
New Approaches ◽  
True Value ◽  
Staging Systems ◽  
Breast Cancer Management

Background A large number of controversies about the management of breast cancer produce uncertainties for patients and physicians alike. In addition, questions are constantly raised about the true value of new approaches or treatments. Methods The authors have conducted a critical review of the literature on several of these issues, and they present a balanced view that can be useful for clinical decision making. Results Although new staging systems for ductal carcinoma in situ have been proposed, a consensus has not yet been reached regarding the criteria to allow tumor excision alone. The extent of benefit of the main adjuvant therapies is becoming better established, and improvement in outcomes may accrue from dose-intensive treatments and autologous stem cell or hematopoietic growth factor support. Conclusions Progress in breast cancer management continues to evolve. Several new approaches either reduce morbidity or improve outcomes.

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